Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 17355 | MA |
NPI | 1043480262 |
---|---|
Provider Name | Mr. Jeffrey Neal |
First Address | Chestnut Hill, MA 02467 |
Second Address | Chestnut Hill, MA 02467-2477 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2008 |
Last Update Date | 27/06/2012 |